{"id":276833,"date":"2025-11-07T07:47:23","date_gmt":"2025-11-07T07:47:23","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/276833\/"},"modified":"2025-11-07T07:47:23","modified_gmt":"2025-11-07T07:47:23","slug":"anthem-northern-light-health-announce-agreement-on-new-contract","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/276833\/","title":{"rendered":"Anthem, Northern Light Health announce agreement on new contract"},"content":{"rendered":"

\t\t\"\"<\/a>Northern Light Mercy Hospital in Portland in 2021. (Gregory Rec\/Staff Photographer)<\/p>\n

Northern Light Health and Anthem Blue Cross Blue Shield\u00a0announced late Wednesday night that they have reached an agreement on a three-year contract to keep health coverage in network for about 30,000 Mainers.<\/p>\n

In a joint statement, the hospital system and insurance company said the contract would be retroactive to Nov. 1. A contract between the two parties for non-hospital services \u2014 including physicians, specialists and walk-in clinics \u2014 ended Oct. 31.<\/p>\n

\u201cThis new agreement allows our patients to continue receiving high-quality care from the providers they know and trust. Northern Light Health has long been a reliable source of care in Maine and will remain that for generations to come,\u201d Northern Light President and CEO R. Guy Hudson said in a written statement. \u201cThroughout the negotiations we kept our patients\u2019 needs at the forefront, and we will continue to advocate for them and the communities we serve.\u201d<\/p>\n

Northern Light is the second-largest health care system in the state and operates Eastern Maine Medical Center in Bangor, Mercy Hospital in Portland, and a network of primary care and specialist services in much of northern and central Maine.<\/p>\n

About 30,000 Anthem enrollees are Northern Light patients, including state employees and some nurses and firefighters.<\/p>\n

\u201cAnthem is deeply committed to ensuring Mainers have broad access to the care they need at prices they can afford,\u201d Anthem President Denise McDonough said in a statement. \u201cWe\u2019re pleased to have reached an agreement that keeps Northern Light Health in-network for our members and helps us continue delivering on our promise to improve lives and strengthen the health of our Maine communities.\u201d<\/p>\n

Karen Sanborn, a spokesperson for Northern Light Health, said Thursday that further details of the deal are being kept confidential, as part of the agreement between the two parties.<\/p>\n

The two sides had been entangled in often-contentious negotiations on a deal \u2014\u00a0which included a formal mediation process that began in August<\/a> \u2014 for several months. <\/p>\n

Mitchell Stein, a Maine-based insurance industry analyst, said a deal was all but inevitable because the downsides for both Northern Light and Anthem for patients being out of network was too great.<\/p>\n

\u201cThere was no way either of those two groups could walk away,\u201d Stein said. \u201cThis is what always happens. They huff and they puff, but it\u2019s always settled. Usually with not this much drama, but it always gets there.\u201d<\/p>\n

After negotiations stalled<\/a> in August, Anthem said Northern Light\u2019s current demands would cause an increase of more than $200 million in health care costs for Anthem\u2019s customers over the life of the proposed three-year agreement. The insurance company said that was \u201cnot in the best interest of our members\u201d and was concerned by Northern Light\u2019s request to drop compensation related to quality of care.<\/p>\n

At the same time, Northern Light sent a letter to Anthem leadership detailing \u201cissues and concerns\u201d that came up during negotiations, including withholding interim payments for services and a \u201ccumbersome\u201d prior authorization operation. <\/p>\n

With the\u00a0contract lapsed<\/a>\u00a0as of Oct. 1 with talks still ongoing, Anthem patients in Maine were considered out of network for a few hours until a one-month contract extension was signed.<\/p>\n

If a patient receives out-of-network services, they typically have to pay higher out-of-pocket costs compared to in-network health care.<\/p>\n","protected":false},"excerpt":{"rendered":"Northern Light Mercy Hospital in Portland in 2021. (Gregory Rec\/Staff Photographer) Northern Light Health and Anthem Blue Cross…\n","protected":false},"author":2,"featured_media":276834,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-276833","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/276833","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=276833"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/276833\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/276834"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=276833"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=276833"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=276833"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}